Prevention of multidrug-resistant infections from contaminated duodenoscopes: Position Statement of the European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastroenterology Nurses and Associates (ESGENA)

In addition to the leak test, visual inspection of the distal end as well as regular maintenance of duodenoscopes should be performed according to the manufacturer's instructions for use, in order to detect any damage at an early stage.

The entire reprocessing procedure in endoscope washer·disinfectors (EWDs) should be validated according to the European and International Standard, EN ISO 15883.

Routine technical tests of EWDs should be performed according to the validation reports.

Microbiological surveillance of a proportion of the department's endoscopes should be performed every 3 months, with the requirement that all endoscopes used in the unit are tested at least once a year.

In the case of suspected endoscopy-related infection, the relevant device (e.g., endoscope, EWD) should be taken out of service until adequate corrective actions have been taken.

Outbreaks should be managed by a multidisciplinary team, including endoscopy, hygiene, and microbiology experts, manufacturers, and regulatory bodies, according to national standards and/or laws.

In the case of suspected multidrug-resistant organism (MORO) outbreaks, close cooperation between the endoscopy unit and the clinical health provider is essential (including infection control departments and hospital hygienists).